The National Committee on Vital and Health Statistics recently warned the Department of Health and Human Services that many in the healthcare industry will not be able to comply with implementing the National Provider Identifier by the target date of May 23, 2007. In a letter to the secretary of HHS, the committee states that providers, payers, health plans, and the Centers for Medicare and Medicaid Services all testified in January that implementation by May is unrealistic. Many providers have not yet applied for an NPI number because they don’t know they need one, or they believe they are exempt if they don’t do electronic billing or participate in Medicare. The other problem is a lack of access to data from the National Plan/Provider Enumeration System, which is preventing plans from building “crosswalks” between legacy provider identifiers and NPIs to verify providers’ NPIs on claims. Also, very little testing has occurred, which is crucial for a smooth exchange of data. Providers expressed concern that payment for claims will be “substantially delayed” without this testing.
The committee urged HHS to publish a data dissemination notice in the Federal Register as soon as possible so that NPPES data can be released, and recommended that education efforts to inform providers of the need to acquire NPIs be intensified. It also recommends that providers be required to get their NPIs and that plans make system changes to accept NPIs by May 23. Testing, however, cannot be accomplished by the deadline, so the committee recommends a six-month grace period from the time HHS issues the data dissemination notice. Read the letter.
